Drug-induced hyperglycemia and diabetes

Area of Science:

• Pharmacology
• Endocrinology
• Drug Safety

Background:

• Drug-induced hyperglycemia and diabetes pose significant health risks and can be asymptomatic.
• Identifying and managing these adverse drug reactions is crucial for patient safety.

Approach:

• Comprehensive literature review of drug-induced hyperglycemia up to January 2023.
• Analysis of official drug databases (Thériaque, Micromedex) for at-risk medications.
• Pharmacovigilance signal detection using VigiBase disproportionality analyses.

Key Points:

• Glucocorticoids, statins, diuretics, beta-blockers, antipsychotics, and others are major drug classes associated with hyperglycemia.
• Mechanisms include altered insulin secretion/sensitivity, pancreatic cell toxicity, and increased glucose production.
• New potential signals identified for phosphodiesterase type 5 inhibitors, endothelin receptor antagonists, and others warrant further investigation.

Conclusions:

• The risk and mechanisms of drug-induced hyperglycemia are diverse and complex.
• Clinician vigilance is essential for early detection and management of these adverse events.
• The therapeutic benefits of prescribed drugs generally outweigh their metabolic risks.